| NPI | 1730308370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA L QUINN Office Manager 586-286-5870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301001421) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2023-06-16 |